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Cardiovascular System
Cardiovascular System
Components
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Circulatory system
Pulmonary system
Purposes:

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Transport O2 to tissues and remove waste
Transport nutrients to tissues
Regulation of body temperature
Circulatory System

Heart

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Arteries and arterioles

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Carry blood away from heart
Capillaries

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Pumps blood
Exchange nutrients with tissues
Veins and venules
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Carry blood toward heart
Cardiac Cycle
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Systole
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Contractile phase of
heart
Electrical and
mechanical changes

Diastole
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Relaxation phase of
heart
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Takes twice as long
as systole
Arterial Blood Pressure

Expressed as systolic/diastolic
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Systolic pressure (top number)

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Normal – 120/80 mmHg
High – 140/90 mmHg
Pressure generated during ventricular
contraction
Diastolic pressure

Pressure during cardiac relaxation
Electrical Activity of the Heart

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Contraction of heart depends on
electrical stimulation of myocardium
Impulse is initiated on right atrium and
spreads throughout the heart
May be recorded on an ECG
Heart Rate
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Range of normal at rest
is 50 – 100 b.m
Increases in proportion
to exercise intensity
Max. HR is 220 – age
Medications or upper
body exercise may
change normal
response
Autonomic Nervous System
Control of Heart Rate

Sympathetic control

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
Stimulates “fight or
flight” response
Speeds up heart rate
and stroke volume
Sympathetic tone
> 100 bpm

Parasympathetic
control



Connected to vagus
nerves
Slows down heart
rate
Parasympathetic
tone 60 – 100 bpm
Components of Blood

Plasma

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Liquid portion of blood
Contains ions, proteins, hormones
Cells

Red blood cells
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White blood cells
Platelets
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Contain hemoglobin to carry oxygen
Important in blood clotting
Hematocrit

Percent of blood composed of cells
Changes in Cardiac Output

Cardiac output increases due to:

Increase in heart rate
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Linear increase to max
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Increased stroke volume

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Max HR = 220 - age
Plateau at ~40% of VO2 max
Oxygen uptake by the muscle also
increases

Higher arteriovenous difference
Causes of High Blood Pressure

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Age
Race
Heredity
Diet
Stress
Inactivity
How to have a heart attack
Everyone’s doing it, so it must be
the “in” thing to do
Be Old

Relative risk of CHD increases with age
Have a family history of CHD

The more blood relatives one has with
CHD, and the younger they are (were),
the higher the relative risk
Be a Man

Males have 5-6 times the relative risk of
CHD of females

Why? Estrogen may be protective
Unalterable Risk Factors for
CHD


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Age
Family History
Sex
Alterable Risk Factors

Things you can do something about…
Be fat
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Obesity increases CHD risk

How much fat is too much?
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Males - > 25%
Females > 30%
Eat a high fat diet
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High fat foods increase plaque within
arteries and contribute to
atherosclerosis
Have High Cholesterol

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Total cholesterol/HGH ratio above:
Males – 4.5/1
Females – 4/1
Increases relative risk of CHD
Have High Blood Pressure

High blood pressure forces the heart to
work harder

How high is too high?
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> 140/90
Smoke
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Smokers are more likely to die of heart
attack than cancer
Smoking is the single most important
alterable risk factor
Be a Type A personality
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Type A personalities are:
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High-strung
Achievement-oriented
Aggressive
Time-conscious
Live a stressful lifestyle
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No one, lying on their deathbed, has
said they wished they had spent more
time at the office.
Have Other Diseases

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Diabetes
Ulcers
Obesity
Don’t Exercise
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If you get the urge to exercise, lie down
until the feeling passes.
Heart Disease and
Stroke Statistics — 2010
Update
Deaths in Thousands
550
500
450
400
350
79
80
85
90
95
Years
Males
Females
00
06
Per 100,000 Population
200
150
130.0
101.5
100
57.0
41.1
50
41.1 39.0
22.9
31.6
0
Coronary Heart
Disease
Stroke
White Females
Lung Cancer
Breast Cancer
Black Females
Age-adjusted death rates for CHD, stroke, lung and breast
for white and black females (United States: 2006).
Source: NCHS.
Deaths in Thousands
1200
1000
800
600
400
200
0
00
10
20
30
40
50
60
70
80
90
Years
Deaths from cardiovascular disease
(United States: 1900–2006). Source: NCHS and NHLBI.
00
06
Coronary Heart
Disease
Stroke
14
7
4
HF*
51
7
17
High Blood Pressure
Diseases of the
Arteries
Other
Percentage breakdown of deaths from cardiovascular
diseases
(United States: 2006) * - Not a true underlying cause.
Percent of Population
90
80
70
60
50
40
30
20
10
0
84.7
73.6 73.1
78.8
39.6 39.6
14.9
8.7
20-39
40-59
Men
60-79
80+
Women
Prevalence of CVD in adults age 20 and older by age and sex
(NHANES 2003-2006). Source: NCHS and NHLBI.
These data include coronary heart disease, heart failure, stroke and hypertension.
2,363
2,500
Number of Transplants
2,107
2,199
2,163
00
08
2,000
1,500
1,000
719
500
22
57
75
80
0
85
90
95
Years
Trends in Heart Transplants (UNOS: 1975-2008).
Source: United Network for Organ Sharing (UNOS), scientific
registry data.
Procedures in Thousands
1400
1200
1000
800
600
400
200
0
79
80
85
90
95
00
06
Years
Catheterizations
PCI
Pacemakers
Bypass
Carotid Endarterectomy
Trends in Cardiovascular Operations and Procedures
(United States: 1979-2006). Source: NCHS and NHLBI.
Note: In-hospital procedures only.
7.1
Obstetrical 72-75
6.5
Cardiovascular 35-39
Digestive System 42-54
5.6
4.2
Musculoskeletal 76-84
2
Female Genital Organs 65-71
1.6
Integumentary System 85-86
Respiratory System 30-34
1.2
Nervous System 01-05
1.2
1
Urinary System 55-59
Hemic and Lymphatic 40-41
0.4
0
2
4
6
8
Millions
Number of Surgical Procedures in the 10 Leading Diagnostic
Groups (United States: 2006). Source: NHDS/NCHS and NHLBI.
Cardiovascular 390-459
324.1
225.2
Digestive System 520-579
Mental 290-319
177.7
175.4
Nervous System 320-389
Injury and Poisoning 800-999
172.9
159.1
Respiratory System 460-519
Musculoskeletal system 710-739
126.1
102.7
Neoplasms 140-239
Genitourinary System 580-629
93.8
87.4
Endocrine System 240-279
0.0
50.0
100.0
150.0
200.0
250.0
300.0
Direct Costs of the 10 Leading Diagnostic Groups
(Billions of dollars) (United States: 2010). Source: NHLBI.
350.0
About cholesterol

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Soft, fat-like, waxy substance
Bloodstream and cells
Needed for cell membranes and hormones and to
make vitamin D
Comes from 2 sources
 Body produces it (mostly genetic) in liver (1000
mg day)
 Food sources (animal products – meats, poultry,
fish, eggs, butter, whole milk, and cheese, not
from plant sources) (100 – 500 mg day)
 Foods with trans fats or saturated fats may
cause the body to produce more cholesterol
About cholesterol
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Must be transported through blood
Carriers are called lipoproteins
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Low-density lipoprotein (LDL)
High-density lipoprotein (HDL)
Lipoprotein = protein + fat
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LDL, more fat, less protein
HDL, more protein, less fat
LDL vs. HDL
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LDL = “bad”
Too much can clog arteries by forming
plaque
Atherosclerosis can cause heart attack
or stroke
LDL vs. HDL
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HDL = “good”
Tends to carry cholesterol away from
arteries and back to liver
May also remove excess cholesterol
from plaque in arteries, slows buildup
Triglycerides
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Form of fat
Also made in body (body fat stored as
triglyceride) and from food
Help transport dietary fat, metabolism
Trigger liver to make more cholesterol,
rising LDL and total cholesterol
Healthy Levels
Total cholesterol
 Optimal – under 200 mg/dL
 Borderline high risk – 200-239 mg/dL
 High risk – 240 mg/dL and up
 LDL
 Optimal – less than 100 mg/dL
 Near/Above optimal – 100-129 mg/dL
 Borderline high – 130- 159 mg/dL
 High – 160 – 189 mg/dL
 Very high – 190 mg/dL
Source: National Cholesterol Education Program,
National Heart, Lung, and Blood Institute
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Healthy Levels
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HDL
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Low - less than 40 mg/dL
High – above 60 mg/dL (may lower risk for
heart disease)
Women tend to have higher HDL due to
estrogen (needs to be over 50 mg/dL)
Triglycerides
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Normal – less than 150 mg/dL
Borderline high – 150 – 199 mg/dL
High – above 200 mg/dL
Common misconceptions
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Using margarine instead of butter will
help lower my cholesterol
Thin people don’t have to worry about
high cholesterol
If a label lists no cholesterol, it’s a
“heart-healthy” choice
Eggs – good or bad?
Women don’t need to worry about
cholesterol
Only middle-aged people should have
What affects cholesterol?
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Diet
 Poly and monounsaturated fats may help
lower cholesterol when used in place of
saturated fats, but still limit
 High carbs, excessive alcohol may increase
triglycerides
 Soluble fiber may lower LDL, not HDL
Weight
Physical activity
Age
Gender
Why does it matter?
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Coronary heart disease is caused by
atherosclerosis
Single leading cause of death
The higher LDL you have plus risk
factors increases risk for heart attack
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Smoking
High Blood pressure
Low HDL
Family history of early heart disease
Age
Atherosclerosis
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Healthy arteries are flexible, strong and elastic. Over time,
however, too much pressure in your arteries can make the
walls thick and stiff — sometimes restricting blood flow to
your organs and tissues. This process is called
arteriosclerosis, or hardening of the arteries.
Atherosclerosis is a specific type of arteriosclerosis, but the
terms are often used interchangeably. Atherosclerosis
refers to the buildup of fats in and on your artery walls
(plaques), which can restrict blood flow. These plaques
can also burst, causing a blood clot. Although
atherosclerosis is often considered a heart problem, it can
affect arteries anywhere in your body. Atherosclerosis is a
preventable and treatable condition.
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Symptoms
Atherosclerosis develops gradually. There are usually no atherosclerosis
symptoms until an artery is so narrowed or clogged that it can't supply
adequate blood to your organs and tissues. Sometimes a blood clot completely
obstructs blood flow, or even breaks apart and causes blood clots that can
trigger a heart attack or stroke.
Atherosclerosis symptoms depend on which arteries are affected. For
example:
If you have atherosclerosis in your heart arteries, you may have
symptoms similar to those of a heart attack, such as chest pain (angina).
If you have atherosclerosis in the arteries leading to your brain, you
may have symptoms such as sudden numbness or weakness in your arms or
legs, difficulty speaking or slurred speech, or drooping muscles in your face.
If you have atherosclerosis in the arteries in your arms and legs, you
may have symptoms of peripheral arterial disease, such as leg pain when
walking (intermittent swelling).
Prevention of high cholesterol
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Get it checked
Watch fats, eat healthy
Consume less than 300 mg of
cholesterol a day
Be active
Quit smoking
Some may need medication
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Lipitor, Crestor, Zocor
Vytorin
Phytonutrients
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Soy protein may reduce risk of heart disease
 Especially when replacing foods high in
saturated fat
Plant sterols
 Found naturally in fruits/veggies, plant oils
may lower LDL
Omega-3 fatty acids
 Two weekly servings of fish may be heart
healthy
Folic Acid
Antioxidants
What Is Asthma?
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Asthma is a chronic lung disease that
can be life threatening if not treated and
controlled.
The cause of asthma in unknown, but
some things make asthma worse.
What Is Happening During
an Asthma Attach ?
When someone is having an asthma
attack the following is happening:
1. The lining of the airway is swollen
and irritated.
2. The muscles around the airway
tighten and make
it hard to breathe.
3. The airway makes a thick mucus.
What Is Happening During
an Asthma Attack in the Lungs?
Asthma Warning Signs
Warning signs are clues that your child’s
asthma may be getting worse.
 Runny stuffy nose
Know Your
Child’s Warning
Signs!
 Headache
 Tickle in throat
 Child’s has a cold or flu
 Coughing
 Restless
What Are the Symptoms
of Asthma?
Not all people with asthma have the same
symptoms
The most common symptoms are:
 Coughing – a cough that may not
go away or may be worse at night

Wheezing – a whistling sound that is
usually heard when breathing out
More Symptoms


Shortness of breath – feels like not
being able to catch a breath
Tightness or pain in the chest – feels
like something heavy has been placed
on the chest
What Causes Asthma
Attacks?
AN ASTHMA TRIGGER IS…
anything that sets off asthma symptoms
TRIGGERS
Ways to Avoid Triggers
Dust, dander, and house mites
 Dust the house with a damp cloth,
especially in the child’s bedroom.
 Use a damp mop to clean the floor.
 Cover pillow, mattress, and boxspring
with special dust-mite–proof covers.
Ways to Avoid Triggers
Smoke
 Try to make the home smoke free by
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Never allowing smoking in the home or car
Never allowing smoking around the child
Quitting smoking
Avoid burning incense or candles.
Ways to Avoid Triggers
Pets
 If possible, remove pets from the home
or limit the child’s contact with the
animal.
 Never allow pets in the child’s bedroom.
Ways to Avoid Triggers
Strong odors and scented products
 Avoid heavy scents, like perfumes,
hairsprays, and certain household
cleaners like bleach or ammonia.
 Don’t use room deodorizers.
Asthma Medications and
Devices
Types of Medications

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Long-term “controller” medicine
Quick-relief “rescue” medicine
Long-Term Medications

Long-term “controller” medicine prevents
swelling and inflammation of the airway
and should be used every day, even when
feeling well.
Quick-Relief Medications


Quick-relief “rescue” medicine works
quickly
to open the tightened airway.
Quick-relief medicine is usually used on an
as-needed basis.
Asthma Devices
Inhaler “the pump”

Delivers inhaled medication in a spray
mist form
Asthma Devices
Inhaler with Spacer

A spacer catches the mist and holds it so it can
be breathed in slowly. This allows the medicine
to reach the person’s lungs.
Asthma Devices
Nebulizer

A machine that delivers medication in a
mist.
Asthma Devices
Peak Flow Meter

A device used to measure how air flows from
your lungs in one “fast blast.”
Controlling Asthma
Getting Asthma Under Control
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See a health-care provider for regular
asthma checkups at least twice a year.
Follow an Asthma Action Plan.
Learn how to take the right medicine
at the right time, the right way.
Getting Asthma Under Control


Learn about asthma triggers and how to
avoid them.
Talk about peak flow monitoring with your
health-care provider.
A Child With Well-Controlled
Asthma
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Sleeps through the night
Goes to school every day
Is able to play, take gym,
and participate in sports